Valdivia, Andres Reyes and Oikonomou, Kyriakos and Milner, Ross and Pitoulias, Apostolos and Reijnen, Michel M. P. J. and Pfister, Karin and Tinelli, Giovanni and Csobay-Novak, Csaba and Pratesi, Giovanni and Ferreira, Luis Mariano and de Vries, Jean -Paul P. M. and Chaudhuri, Arindam (2024) Endosutured Aneurysm Repair of Abdominal Aortic Aneurysms with Short Necks Achieves Acceptable Midterm Outcomes - Results from the Peru Registry. ANNALS OF VASCULAR SURGERY, 106. pp. 80-89. ISSN 0890-5096, 1615-5947
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Background: The study aims to describe midterm outcomes following treatment of infrarenal abdominal aortic aneurysms (AAAs) with short necks by endosutured aneurysm repair using the Heli-FX EndoAnchor system. Methods: This is a retrospective study of prospectively collected data from 9 vascular surgery departments between June 2010 and December 2019, including treated AAAs with neck lengths <10 mm. The decision for the use of EndoAnchors was made by the treating surgeon or multidisciplinary aortic committee according to each center's practice. There were 2 Groups further assessed according to neck length, A (>= 4 and <7 mm) and B (>= 7 and <10 mm). The main outcomes analyzed were technical success, freedom from type Ia endoleaks (TIaELs), sac size increase, all -cause and aneurysm -related mortality. Results: Seventy-six patients were included in the study, 17 fell into Group A and 59 into Group B. Median follow-up for the cohort was 40.5 (interquartile range 12-61) months. A median of 6 (interquartile range 3) EndoAnchors were deployed in each subject. Technical success was 86.8% for the total group, 82.4% and 88.1% ( P = 0.534) for Groups A and B respectively. Six out of 10 (60%) of TIaELs at the completion angiographies showed spontaneous resolution. Cu- mulative freedom from TIaEL at 3 and 5 years for the total group was 89% and 84% respectively; this was 93% and 74% for Group A and 88% at both intervals in Group B ( P = 0.545). In total, there were 7 (9.2%) patients presenting with TIaELs over the entire study period. Two (11.8%) in Group A and 5 (8.5%) in Group B ( P = 0.679). There were more patients with sac regression in Group B (Group A = 6-35.3% vs. Group B = 34-57.6%, P = 0.230) with no statistical signif- icance. All -cause mortality was 19 (25%) patients, with no difference (4-23.5% vs. 15-25.4%, P = 0.874) between groups; whereas aneurysm -related mortality occurred in 1 patient from Group A and 3 from Group B. Conclusions: This study demonstrates reasonable outcomes for patients with short -necked AAAs treated by endosutured aneurysm repair in terms of TIaELs up to 5 -year follow-up. EndoAnchor use should be judiciously evaluated in short necks and may be a reasonable option when anatomical constraints are encountered, mainly for those with 7-10 mm neck lengths. Shorter neck length aspects, as indicated by the results from Group A, may be an alternative when no other options are available or feasible.
| Item Type: | Article |
|---|---|
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Dec 2025 09:26 |
| Last Modified: | 16 Dec 2025 09:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65454 |
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